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#691
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Bicyclist Fatalities in AZ 2009
On 12/1/2010 11:34 PM, Frank Krygowski wrote:
On Dec 1, 11:29 pm, wrote: On Dec 1, 6:41 pm, Tºm Shermªn™ °_° I would expect that if everyone had proper lights, reflectors, brakes, and rode in a vehicular cycling manner while sober, those 700-800 deaths per year in the US would drop to less than 100. No. They might drop by about half. Most of the adult victims are in fact killed while riding lawfully. So that would get annual bicycle deaths down to the level of annual deaths from drowning in one's own bathtub. (332 that year, I believe.) Hmm. But I bet we'd still hear "Bicycling is dangerous!" - Frank Krygowski Do more people bathe or cycle? -- Tºm Shermªn - 42.435731,-83.985007 I am a vehicular cyclist. |
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#692
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OT - Medical Costs
On Dec 1, 9:23*pm, Tºm Shermªn™ °_° ""twshermanREMOVE\"@THI
$southslope.net" wrote: On 12/1/2010 10:40 PM, Jay Beattie wrote: On Dec 1, 6:17 pm, T m Sherm n _ ""twshermanREMOVE\"@THI $southslope.net" *wrote: On 12/1/2010 1:53 AM, Radey Shouman wrote: The premise of the question was that the plumbing was done, but the bill was many times the estimate. *I would think your options would be to pay the bill (and maybe learn plumbing for next time), negotiate, take the plumber to court ... If I did that at work, the clients would only pay up to the estimate, and tell me to sod off if tried to collect the rest (and the courts would agree with them if I sued in an attempt to collect of the excess fees). An estimate is an estimate and not a bid -- although some contractors treat bids like estimates. *A bid is an offer to perform work for a specific charge, and once accepted by the customer, it is binding. *An estimate is just a projection of cost based on standard charges (like hourly rates). *I got a bid from a geotech recently, and the final bill was actually less than the estimate -- which made me pretty happy. *I was also happy to find out that my house was not slipping down the hill. -- Jay Beattie. Are not some estimates binding by consumer protection laws? By the way, I said I got a bid from a geotech when I meant to say that I got an estimate. I'm glad it was not a bid, because then I would have paid more than actual hourly rate. Anyway, I don't know the answer to your question because it varies from state to state. Around here, residential construction contracts have to be in writing, but contractors can provide services on a time and materials basis (with an estimate) or a bid basis. There may be special state laws that apply to auto shops and other consumer service providers, but I don't know of one in particular. Most written estimates have long provisos stating that it is only an estimate and that final charges may vary. That's why I always put in a "not to exceed without approval" -- but even then, I can get reamed. Most states prohibit consumer fraud of various kinds, so there may be some law out there that broadly defines fraud as an estimate that is way off base, but I'm just guessing on that . -- Jay Beattie. |
#693
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Bicyclist Fatalities in AZ 2009
On Dec 2, 4:48*pm, Tºm Shermªn™ °_° ""twshermanREMOVE\"@THI
$southslope.net" wrote: On 12/1/2010 11:34 PM, Frank Krygowski wrote: On Dec 1, 11:29 pm, *wrote: On Dec 1, 6:41 pm, T m Sherm n _ I would expect that if everyone had proper lights, reflectors, brakes, and rode in a vehicular cycling manner while sober, those 700-800 deaths per year in the US would drop to less than 100. No. They might drop by about half. Most of the adult victims are in fact killed while riding lawfully. So that would get annual bicycle deaths down to the level of annual deaths from drowning in one's own bathtub. *(332 that year, I believe.) Hmm. *But I bet we'd still hear "Bicycling is dangerous!" - Frank Krygowski Do more people bathe or cycle? Do the same demographic bathe and cycle? JS. |
#694
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Bicyclist Fatalities in AZ 2009
On 12/2/2010 12:52 AM, James Steward wrote:
On Dec 2, 4:48 pm, Tºm Shermªn™ °_°""twshermanREMOVE\"@THI $southslope.net" wrote: On 12/1/2010 11:34 PM, Frank Krygowski wrote: On Dec 1, 11:29 pm, wrote: On Dec 1, 6:41 pm, T m Sherm n _ I would expect that if everyone had proper lights, reflectors, brakes, and rode in a vehicular cycling manner while sober, those 700-800 deaths per year in the US would drop to less than 100. No. They might drop by about half. Most of the adult victims are in fact killed while riding lawfully. So that would get annual bicycle deaths down to the level of annual deaths from drowning in one's own bathtub. (332 that year, I believe.) Hmm. But I bet we'd still hear "Bicycling is dangerous!" - Frank Krygowski Do more people bathe or cycle? Do the same demographic bathe and cycle? I have no statistics, but I expect that cyclists would tend more to shower than bathe (bathe implying partial immersion in a recumbent position, in a partially full bathtub, in this context). -- Tºm Shermªn - 42.435731,-83.985007 I am a vehicular cyclist. |
#695
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OT - Medical Costs
On Dec 1, 10:20*pm, Tºm Shermªn™ °_° ""twshermanREMOVE\"@THI
$southslope.net" wrote: On 12/1/2010 10:50 PM, DirtRoadie commented: I assume your expertise comes from your having been sued a BUNCH or from trying to collect on unjustified billings. Yes, never lost /sarcasm 'Nuff said. It explains your bitterness. |
#696
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OT - Medical Costs
On 12/1/2010 8:02 PM, Frank Krygowski wrote:
On Dec 1, 5:32 pm, Peter wrote: On 12/1/2010 12:23 PM, (PeteCresswell) wrote: With paper, he tells an assistant to assemble the histories - then he flips open each folder and spreads/eyeballs the paper in a matter of seconds. Yes, but now he doesn't need the assistant. Right. The doctor does the work himself - instead of tending to curing patients. Part of "curing the patient" may come from "assembling the history". Or maybe the history should be pre-assembled, or assembled in multiple ways depending on what the doctor is trying to analyze. Much of what application software does is codify process. Most often, the process remains unchanged after the conversion. As a software designer, I can attest to the gross inefficiencies that arise from computerizing an existing process without taking advantage of computer strengths and avoiding weaknesses, and leaving the process unchanged. As an implementer/seller, I realize that many organizations have a difficult time computerizing without the added challenge of process redesign, and yet without doing that, a crappy outcome is pretty certain. When I started at this university, purchasing equipment was quite easy, most of the time. There was a good equipment replacement budget, and there was also a good purchasing department. If I needed something for the lab, I could describe it to the guy in Purchasing, he'd dig and find me alternatives, I'd pick one, fill out a simple form and equipment would soon arrive. (The vendor probably gave the Purchasing guy a bottle of scotch and a box of chocolates at Christmas, but that was OK with me.) Then the university decided to computerize the operation, as they did many other operations. So instead of six people in Purchasing being the experts at buying things, every department secretary had to learn to become expert at finding things, and at operating the arcane software. And of course, the secretaries (unlike the Purchasing guy) knew nothing about dynamometers, or strain gages, or even thermometers, let alone other lab apparatus. So the faculty members ended up doing most of the work. We see the same thing everywhere. Unless you're in Oregon or Jersey, you get to pump your own gas. Increasingly, you get to check out your own groceries. Even if you don't, you get to scan your own credit card and figure out which buttons to hit to make the purchase go through. ("Wait - not yet - OK, now try scanning that again...") Don't train the cashiers and let them do it; instead, train the entire population and make them figure out every different system at every different gas station and retailer. The work is being off-loaded to those who can't refuse it. And the jobs are being taken away from the lower-skilled set. - Frank Krygowski Broadly speaking there are 2 approaches to raising productivity with computer systems: 1) Enable skilled workers by giving them more information faster (so called "decision support") and automating the repetitive drudgery; and 2) "Dumbing down" the job to allow replacement with cheaper, less skilled people. The purchasing example you chose follows strategy #2. I have implemented purchasing systems that went with #1. In one case (distributor), their business went from $20-200M, while their purchasing head count stayed the same. The purchasing agents were happier, backorders went down, and warehousing costs went down. It turned out to be a good outcome for the purchasing agents (fortunately the company was growing fast enough to absorb the increased productivity), but they (PA's) still fought it tooth and nail. Despite the savings, management wasn't entirely pleased since they felt the system overly empowered the PA's. In another application involving sales support, management expressly dictated their goal of not making their sales people more productive, but narrowing the gap between the average and the "stars", allowing them to negotiate down commissions. The choice of approach has little to do with technology and everything to do with management policy. I declined to implement one call center application where the primary purpose was to monitor agents. Not that I was sure that management would use it abusively, it's just not the kind of work that gives me much satisfaction. The other examples you gave (checkout & pump gas) are common where self-service replaces minimum wage workers. These don't require computer systems, strictly speaking. In some cases, it's a better way to go for the customer. I prefer to do most of my buying on-line, even groceries. Of all the BS that came out of the "dot com" era, there was one concept that proved durable -- "dis-intermediation". One of the reasons that so many goods and services are expensive is that there are so many middlemen in the chain. In some cases they add value, in many not, or at least only subjective value. Retooling the process can generally lower costs and improve quality, but there will (as with any substantive change) be winners and losers. Even the eventual winners often feel threatened enough to fight the changes, though. |
#697
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Bicyclist Fatalities in AZ 2009
On 12/1/2010 8:41 PM, Tºm Shermªn™ °_° wrote:
On 12/1/2010 6:03 PM, Frank Krygowski wrote: [...] If you want to reduce the 762 bike deaths, enforce headlights at night. Enforce riding on the correct side of the road. Keep cyclists out of door zones. Educate drivers about our right to ALL roads, and punish drivers who screw up. Don't yell that biking is terribly dangerous. That's counterproductive. Indeed, there was a study (need to find the citation - anyone?) that club recreational cyclists had a much lower serious accident and fatality rate than people on bicycles as whole, and commuter cyclists had even lower accident rates. I would expect that if everyone had proper lights, reflectors, brakes, and rode in a vehicular cycling manner while sober, those 700-800 deaths per year in the US would drop to less than 100. Frank has made similar claims, but the statistics just don't seem to support them. |
#698
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OT - Medical Costs
On 12/1/2010 10:53 PM, Tim McNamara wrote:
In , wrote: I guess this means that Steve Jobs' job is safe, Steve isn't selling EMRs. Maybe he should- the iDoc with integrated wireless connectivity between servers, laptops and iPod Touches. but I cannot imagine anything that could equal the ease and speed of the physician's just spreading and eyeballing the paper - except for having the aforementioned hourly employee print out the relevant material and put it in a folder as before. What happens at most of the places I consult is that someone prints out the records for me, because all the computers are in use by their employees and for me to access the computer means that someone else can't get their job done for that time. I then type the relevant information into my report on my laptop, use the back side of their printouts for taking notes during my interviews and consultations, type that information into the report, print it to give to them to be filed and shred the stuff they gave me unless there is specific reason to keep it. EMRs are generally not designed to accommodate outside consultants, unfortunately. And, even if they were, the law requires me to have a copy in my files at my clinic as well as a copy in the chart at the medical facility... so I'd still have to print. You are just describing run of the mill systems integration problems. In your case, the resident systems at the facilities you visit (with or without actually visiting, ideally) should allow you access (limited, secure, etc.) to the data you need without printout & rekeying. I've implemented many applications that did nothing more than exchange/merge/update information between various systems, it's a major IT task. |
#699
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Bicyclist Fatalities in AZ 2009
On 12/1/2010 8:44 PM, Tºm Shermªn™ °_° wrote:
On 12/1/2010 7:47 AM, Duane Hébert wrote: On 11/30/2010 11:57 PM, James wrote: On Dec 1, 2:31 pm, Frank wrote: On Nov 30, 10:02 pm, wrote: On Dec 1, 1:21 pm, Tºm Shermªn™ °_°""twshermanREMOVE\"@THI $southslope.net" wrote: On 11/30/2010 3:24 PM, James Steward wrote: [...] Anyone riding on the road with motor traffic is in constant mortal danger.[...] Anyone alive is in constant mortal danger. I thought I mentioned that already. Then James, try mentioning it more often regarding other activities, would you? Why? We're discussing cycling, aren't we? I don't know if you can get Time magazine in Australia. Yes it is here. But the December 4, 2006 American issue has, on page 68, an excellent graphic and table discussing mortal dangers, i.e. causes of death in the US. Maybe they did one for Australia, as well? Maybe they did, though I couldn't care less. We're discussing cycling. US deaths for 2003 are shown as a great 3 dimensional pyramid, divided into horizontal slices by causes of death. The largest volume slice, at the pyramid bottom, is heart disease. 685,089 of those. The slice for "other diseases" not otherwise mentioned has 681,150. For cancer, 556,902. For stroke, 157,689. Certain respiratory diseases, 126,382. Diabetes, 74,219. Maybe you should make it your mission to improve peoples eating habits. Jamie Oliver showed us what some schools in the US served the children there. _All_ accidents combined cause only 4% of US fatalities, or 109,277. Oh well, if that's the case, why aren't you campaigning for no seat belts and no air bags in vehicles too. Why not forget about vehicle safety standards all together. After all, there are much more important things. Of those, the biggest sub-category by far is motor vehicle accidents, _not_ including bike deaths, at 44,757. Who would have thought it. Apparently those that suggest that the best way to improve cycling safety by riding in traffic. Not that I have a problem with riding in traffic but suggesting that it's safer doesn't make sense to me. Maybe I didn't get the force field attachment on my bike. butbutbut [1], most facilities *do not* separate cyclists from traffic at intersections, but rather increase the danger to cyclists at intersections. Therefore, it is no surprise that vehicular cycling would be safer, since being run over from behind or sideswiped while cycling is only a small fraction of the total number of accidents. I'm not going to argue with you about what "most" facilities do. I've ridden on many that are well designed. I am also not convinced that rear ends and especially side swipes are so rare but if they are couldn't it be partially due to the fact that not many people ride in traffic? If driving in traffic is apparently so dangerous for cars, and I totally agree that it is, then why would it be less dangerous for cyclists who are less visiblee than cars and aren't even protected by 2000 lbs of steel? This is the part that I don't get. |
#700
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Bicyclist Fatalities in AZ 2009
On 12/1/2010 9:34 PM, DirtRoadie wrote:
On Dec 1, 6:49 pm, wrote: On Dec 2, 11:50 am, Frank wrote: "Although the risk of injury while bicycle commuting is real, it has been difficult to accurately measure. Two large retrospecive studies of North American bicycle commuters found the injury incidence to be between 6.0 and 18.6 per 100,000 miles commuted. A 2-week pilot study of commuters in Nottingham, England recorded no injuries." google "A 2-week pilot study of commuters in Nottingham, England recorded no injuries" Hit this.http://hej.sagepub.com/content/60/4/293.abstract "We calculated that commuters covered 5368 km, averaging 4.6 km per journey (range 0.8 to 7.6 km), 57 per cent of it on roads. Twenty- eight cyclists reported 53 incidents (10 per 1000 km: 95%CI 7 to 13). Segregated cycle paths had the highest rates (43 per 1000 km: 95%CI 26 to 67). In 46 cases the incident involved taking action to avoid an obstacle, a pedestrian, another cyclist or a motor vehicle. No injuries were reported in these incidents and nobody involved in the incidents attended the hospital A&E department. " Not a particularly long study, if there were 20 injuries per 100000 miles, they may easily have missed seeing an injury over that 2 week period, and of course if the injury rate is lower the likelihood of any injury being recorded diminishes further. Nottingham may be a relatively safe area to cycle. Where I cycled in the UK, near Crawley and south to Brighton, I felt in less peril than I do riding to Melbourne from home. JS. Nice find. But you left out the best quote: "It is likely that the higher rate of injury on off-road cycle paths reported in other countries would be confirmed." Likely confirmation of a higher rate of injury kinda' leaves Frank with just the pits from his carefully picked data cherries. Off-road cycle path seems pretty open as well. Could be flat trail through a park or a dirt bike trail down a mountain side. |
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